A primary goal of minimally invasive surgical procedures is to minimize the adverse effects of the procedure on the patient. This reduces post-surgical trauma and pain and minimizes recovery time. Some minimally invasive procedures require the surgeon to create one or more small incisions through which various surgical instruments can be passed. Other minimally invasive procedures forego the need to create small incisions in the exterior of the patient, instead relying on surgical instruments such as, for example, flexible endoscopes that can be passed into the interior of the patient's body by entry through a natural bodily orifice.
FIGS. 1 and 2 depict a traditional flexible endoscope 20 which can be utilized by a surgeon to remotely view and manipulate tissue within the body of a patient. As illustrated in FIG. 1, a traditional flexible endoscope 20 generally comprises a control body 22 that connects to an insertion tube 24. The control body 22 remains outside the patient, while the flexible insertion tube 24 is inserted into the interior of the patient via either a naturally occurring or man-made orifice. Depending on the intended function of a specific flexible endoscope, the insertion tube 24 can include, for example, various channels for performing suction, biopsy, irrigation and insufflation. The insertion tube 24 may also include fiber optics or light bundles for conveying light from an external light source to the interior of the patient, as well as conveying images from the interior to an exterior camera. A connector 32 allows the endoscope 20 to connect to one or more various related system components, including, for example, a power supply, a light source, a camera and/or video processor. Endoscope 20 may also include additional control means 30 for controlling one or more functions of the endoscope, such as, for example, a manipulator or other tissue processing means that extends out from the distal tip section 26 of the endoscope 20.
In practice, the insertion tube 24 is inserted into a man-made or naturally occurring orifice of the patient and then slowly advanced into the interior of the patient. One or more controls 28 typically located on the body 22 of the endoscope 20 allows for the surgeon to manipulate or bend the distal tip section 26 of the flexible endoscope as he or she advances the insertion tube 24 through the patient. In this manner, the surgeon can steer the tip 26 of the endoscope as it is advanced through the interior of the patient's body.
Thus, as illustrated in the example of FIG. 2, a surgeon can utilize a flexible endoscope 20 to view and manipulate the tissue of a patient's upper gastrointestinal tract, and beyond, by inserting the distal tip section 26 of the endoscope 20 into the mouth 44 of the patient 42. The surgeon then advances the insertion tube 24 down the patient's esophagus 46 until the tip region 26 of the endoscope 20 is in the region of tissue that he or she wishes to examine, i.e., the stomach 48 or duodenum 50. Alternatively, if the region of tissue that the surgeon wishes to examine lies beyond the stomach 48, the surgeon can utilize the flexible endoscope 20 or other surgical instrument to make an incision in the wall of the stomach 48. The flexible endoscope 20 can then be passed through the newly-created incision and advanced outside the stomach 48, allowing the surgeon to examine the exterior of the stomach 48 and surrounding tissue, or alternatively, advance the endoscope 20 beyond the surrounding tissue in order to examine anatomical regions more distant from the stomach 48.
As demonstrated by the above example, endoscopic surgical procedures typically involve the surgeon having to examine and work upon a target area of tissue that is located some distance from the opening (e.g., naturally occurring or man-made orifice) that the surgical instrument is passed through in order to gain entry into the interior of the patient body. Furthermore, as the distance between the opening and target area of tissue increases, so does the complexity of the surgical procedure. Guiding the endoscope through the tissue of the patient to the target area may be relatively straightforward when the target area of tissue is located adjacent or proximal to the opening through which the endoscope enters the interior of the patient. However, as the distance between the opening and target area of tissue increases, so does the complexity of the endoscopic procedure. An increasing distance between the opening and target area of tissue results in the potential number of paths that the endoscope can be guided along to increase exponentially.
When presented with numerous potential surgical trajectories or paths between the opening and target area of tissue, the surgeon is then faced with the problem of determining and following the one trajectory that is deemed most optimal for the surgical procedure. Usually the most optimal trajectory is considered to be the path that minimizes the potential for tissue damage to the patient while still delivering the endoscope to the target area. In current endoscopic procedures, determination of the optimal surgical trajectory is made solely by the surgeon based on his or her anatomical knowledge and prior surgical experience. Consequently, a procedure performed by a seasoned, highly-experienced surgeon may result in the selection of the most optimal and safest surgical trajectory, while the same procedure performed by a younger, less-experienced surgeon may result in the selection of a less-than-optimal surgical trajectory that can increase the chance of complications during the procedure.
Disadvantages in current navigational methods continue to exist even when only highly-skilled surgeons are performing the procedures. Variations among surgeons with respect to procedural methods and preferences can result in significant differences in the selection of the optimal surgical trajectory for a specific surgical procedure. The selection of a sub-optimal trajectory by even the most skilled surgeon can also occur simply due to time constraints. The typical surgical schedule can be quite hectic, providing the surgeon with limited time to spend on analyzing and planning an upcoming surgery. Consequently, the surgeon may not have considered the selection of many different, or possibly any, alternative trajectories or paths. Determining and selecting the optimal surgical trajectory becomes even more difficult during the surgical procedure itself. Even if an initial optimal trajectory was selected during the beginning of the procedure, many surgeons end up having to revise their earlier decision and select a new trajectory as the procedure progresses due to factors such as anatomical variation amongst patients as well as virtually any minor or major surgical complication that results in the surgeon having to deviate from their initial plan.